Knowledge and Awareness of Vitamin D Among Pregnant or Lactating Iraqi Refugee Women: a Call for Different Approaches in Health Education and Outreach

Abstract

Vitamin D deficiency during pregnancy and lactation has neg- ative impacts on maternal, fetal, and infant health. Low health literacy and other social determinants of health may increase the risk of deficiency among refugee women. This qualitative study used a survey and in-depth individual interviews to ex- amine knowledge of vitamin D among ten pregnant or breastfeeding Iraqi refugee women in the United States, and sought participants’ recommendations on culture-centered and participatory health promotion strategies. All participants re- ported having insufficient information and understanding of vitamin D, its health benefits, and the risks of deficiency. The four primary themes that emerged from the interviews were the quality of available vitamin D information, barriers to seeking such information, intersectionality of health and environ- ment, and power differentials and the control of the health agenda. Participants’ recommendations included bridging the language barrier and training health care providers to deliver the information needed to raise awareness. The findings of this study provide an opportunity for public health systems to design culture-centered health education and promotion strategies to ensure vitamin D adequacy among this vulnerable population.